Calcium channel blocker dosage

[Fabfibber]

Hi all,

I am on Cordilox (AKA Verapamil) which is a calcium channel blocker. Currently taking 2x40 mg twice a day = 160mg/day.

Cardiologist suggested I change to one SLOW RELEASE 180mg tablet/day. When I asked. why he kind of said it will result in more even levels of the drug through the day. He also said it will be easier for me to take it only once a day. I reminded him that I take medication twice a day, so this is not a benefit and that my objectives are lowest levels of drugs and greatest efficacy. I asked 2 pharmacists and my GP and it seems not one knows which is better normal (instant release) 2x 12 hours apart or similar dosage of Instant Release once a day.

Cardiologist also said I could try 90mg of Slow Release once a day, if I have no ill effects. This would necessitate breaking the 180mg Slow Release in half.From pharmacists and GP I got differing views as to whether or not one can break Slow Release Verapamil/Cordilox in half. It has a score line down the middle.

Any info you can give will be much appreciated. Wishing you a good day.

[mjames1]

Not Verapamil, but I had a similar situation with a similar calcium channel blocker, Diltiazem.

I was taking 30mg fast acting tabs every six hours and the doc offered me 120mg time release capsules. I did not like the time release. In fact, I found the delivery more uneven, not less, with spikes in the afternoon. So I went back to 30mg every six hours.

Yes, a bit of a PITA with 4x/day dosing and waking up at 2am for a dose, but the side effect profile for me was less and I also felt more in control in that I could titrate up (or down) my dose better when needed, as in the case of an afib episode.

That said, I may go back and try the 120mg time release at some point and see how I feel again. Maybe my body will react differently now.

My suggestion is to try it both ways. They do essentially the same thing, but if you feel better with one formulation, go with that. If you feel the same, then go with the time release so you don't have to set your alarm clock at night.

Jim

[JOY2THEWORLD49 in reply to mjames1]

Hi

My 120mg Diltiazem has proven to not cover me for the full 24 hrs. So I also take

Bisoprolol 2.5 at night.

It's not that the Diltiazem is not feeding me meds evenly across 24 hr but it runs out at the end of the day.

Good for me in a way as H/R Night never changes from an average of 47. I wouldnt

want it any lower. I had the stroke at 2am. Retiring at 10-11pm.

cheers JOY. 74. (NZ)

[KMRobbo]

when first diagnosed AFIB and finding out I could not tolerate beta blockers I was put on Verapamil half securon 120mg mod release. The cardiolgist let me try a half dose and was happy to let me cut the tablets up. I was also given 40mg standard release tablets with a view to supplementing the dose if I got an AFib episode.

I actually ended up taking the 120mg and using the 40mg tabs to supplement when necessary

If remember half securon were also supplied as capsules, which could NOT be cut in half.

[Rosemaryb1349]

I was put on Verapamil half securon 120mg once a day when I refused to go back to BBs (zombie) I find them convenient and effective but mine don't have the dividing half line. On occasion I have had these Tablets crumbling when I push them out through the foil particularly when I use a small plastic device made for that purpose. Seems to be just one whole pack then next one is OK.

[JOY2THEWORLD49 in reply to Rosemaryb1349]

Hi'

Check the expiry date because that's why mine crumbled for Bisoprolol.

cheri JOY. 74. (NZ)

[Buffafly]

I take 180mg slow release diltiazem as a capsule, don’t notice spikes. At one time I took 120capsule with 60mg slow release tablet to use as PIP when I had an episode but my GP thought it was better to take all the time because it has a mild preventative effect as well.

[Scat319]

I also take 120ER once a day of Diltiazem and use the 30mg as a pill in pocket if I get a run of afib (rarely for me thankfully). I like the once a day pill.

[JOY2THEWORLD49]

Hi

I was offered CCB Diltiazem. The 180mg (1/2 normal took me down 105 beats per minute within 2 hours.

Twinked I take Diltiazem 120mg AM

Bisoprolol 2.5mg PM.

BP 123/70. 69 - 88 H/R Day

With throxin as well in morning I still get exertion no energy and need to stop what I am doing.

Is it the heart enlargement Left Chamber and told no Ablation for me.

cheri JOY. 74. (NZ)